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Project

Management of Visceral Leishmanisis in Muzaffarpur, Bihar, India

Human visceral leishmaniasis (VL), also known as Kala-azar (KA), is a major health problem and cause of mortality, particularly in developing countries. Leishmania organisms are endemic in more than 80 countries and 350 million people are considered to be at risk (Desjeux P 2004). More than 90% of the cases worldwide occur in Indian subcontinent, Brazil and Sudan. In India, 90 percent of the VL cases are reported from a single state, Bihar. The disease is fatal if left untreated and case fatality ranges from 5 to 15% even with treatment (Boelaert M et al 2000). In Indian sub-continent humans are the only known reservoirs of the parasite.
In India, a centrally organized and sponsored VL Elimination Initiative was launched in endemic areas in 2005. The National Kala-azar elimination program is based on vector control by Indoor Residual Spraying (IRS) of houses and cattle sheds; and early detection and treatment of cases in VL endemic districts. The program relies on the public primary health care system at district and block levels (Hasker E et al 2010) and it is monitored using passive surveillance.
The passive surveillance system in use fails to record the majority of cases started on treatment because they are treated by the private health sector and does not provide reliable information on treatment outcomes, even for those treated within the public health system. Inadequate surveillance is causing lack of information on disease burden which in turn magnifying the severity of the problem. Hence, an adequate surveillance system, where all key documents, past and current surveillance data, and other relevant information could be integrated and, rapid and timely analysis for the management and evaluation of the VL elimination programs could be possible, is the need of the time.
Datum:14 jun 2012 →  30 apr 2015
Trefwoorden:B680-volksgezondheid